Claim total
$917.37
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-11-01
- Stop
- 2011-11-01
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Douglas Will
- Payer
- payer Anthem
Record id
047ee4ec-c50b-b504-0222-19142a0da0cf